The aim of critcial appraisal is to ensure the clinical research articles are reliable, valid and applicable before it is applied to a patient.
In this assignment you are required to critically appraise a systematic review paper. You must select a systematic review paper that is related to a nursing practice of your choice. There are many critical appraisal tools available, but you only need to select one to assist you in writing this assignment.
Review of the Problem
The healthcare sector comprises of a diverse range of patients and care givers entrusted with the responsibility of providing care to the patients (Davis, Lind & Sorensen, 2013). However, research studies have revealed that on account of excessive work load and work pressure a major dearth of burnout among the nursing professionals have been witnessed on a global scale (Drury et al., 2014). Typically the issues that have been co related as an outcome of the burnout in oncology nursing professionals can be enlisted as emotional exhaustion, depersonalization and feelings associated with stagnant personal growth and achievement (Gomez-Urquiza et al., 2016). Burnout can be characteristically defined as a psychological condition, where in the nurses on being regularly exposed to occupational stress turn out to be emotionally barren and at the same time it affects the person centered relationship with the client (Foureur et al., 2013). Reports have revealed that due to the lack of interventions and programs aimed at promoting positive outcomes to nullify the effect of the burnout syndrome, the prevalence of the issue is at a hike (Guveli et al., 2015). With the nursing profession being associated as the noblest of profession to nurture mankind, this particular issue can be considered extremely significant as it would help in critically evaluating the factors that have contributed to the present scenario. This particular paper revolves around the critical analysis of the systematic review presented by the authors. It would constructively create a critique with the use of an authentic critical appraisal tool and would delve deeper into the seriousness of the scenario.
Review of the problem: The problem would be reviewed based on the PICO format in order to extract a significant research question:
On the basis of the identified PICO elements, the research questions that can be framed in order to conduct an effective critical evaluation would include the following:
- Does the paper effectively evaluate the levels of EE, D and PA among the oncology nurses?
- What are the estimated levels of EE, D and PA in oncology nursing professionals?
- What factors lead to burnout of oncology nursing professionals?
In order to critically appraise the article, the critique tool that has been chosen by me is the JBI critique tool.
Yes, the review question is clear and explicitly stated in the systematic review. The author mentions the review questions in an extremely systematic manner and the entire review revolves around the set of devised review questions. The authors developed the review questions centered around the oncology professionals and aimed at accessing the factors causing burnout and also evaluate the level of EE, D and PA among the professionals (Gomez-Urquiza et al., 2016). The authors have been able to clearly state the review question as the systematic review revolves around the central theme of the review questions.
Yes, the inclusion criteria were appropriate for the review question. The inclusion criteria comprised of identifying the qualitative research studies so that primary data could be obtained. The research papers included adhered to the MBI scale to measure the burnout (Gomez-Urquiza et al., 2016). The justification that has been given by the author for using the MBI scale as the inclusion criteria to measure nurses burnout is two-fold. Firstly, MBI forms the universal tool to measure burnout and secondly, any other tool would not facilitate an easy integration of the results (Hegney et al., 2014). However, other inclusion criteria that have been chosen by the authors included publication at any date and in language other than English such as in Spanish and Portugese (Gomez-Urquiza et al., 2016). It can be commented here that the language could have been restricted to English to facilitate better search strategy and the publication date could have been limited to the 10 years span as reviewing research articles published prior to that is considered obsolete reference to be included in a systematic review.
PICO Format
Yes, the search strategy was appropriate and it incorporated the best databases such as CINAHL, Medical, ProQuest, PubMed, Scopus and so on. The databases that have been searched for the retrieval of relevant scholarly articles are extremely authentic and no questions can be raised about the validity of the research papers published on these databases (Gomez-Urquiza et al., 2016). The key search terms that were used were oncology nursing and burnout and the languages that were screened included English, Spanish and Portugese. The key search terms used by the authors included the appropriate search terms on which the entire systematic review is based upon. However, it can be said that the key terms were extremely generalized and did not include any specific terms on which the research could have been formulated. Also, the search strategy did not stringently apply filters on the research publication years or the languages of the research articles. These characteristic criteria could have been improvised in order to incorporate better search strategy and address the PICO questions effectively at the same time (Jones et al., 2013).
Yes, the sources and resources used to search for the studies were adequate. The authors have use no date biasness or language biasness while searching relevant literatures on the scholarly databases such as CINAHL, Medical, PubMed, ProQuest and Scopus (Gomez-Urquiza et al., 2016). This can be counted as a positive strategy as it has helped the authors in assembling all relevant literatures and at the same time formulate the key concepts of the relevant literatures to synthesize the review. The non inclusion of stringent year or date can be termed as a helpful tool that facilitated the authors to combine and successfully gather the theme of the systematic review without encountering the issues related to publication biasness (Li et al., 2014).
Yes, the criteria for appraising studies were appropriate. The authors have efficiently considered the characteristics and thoroughly reviewed the research papers. This can be commented on the basis of the appendix provided at the end of the paper by the authors that critically comprises of all the articles that were reviewed, the corresponding study design and a brief about the study type. The brief critically included the core on the universal MBI scale and at the same time, the risk factors associated with the cause of burn out syndrome (Gomez-Urquiza et al., 2016). Hence, it can be said that the criteria undertaken for the appraisal of the research papers is appropriate and at the same time extremely methodical.
Yes the critical appraisal was conducted by two different review teams and on encountering an aspect that posed a dispute of opinion a third team helped in building a constructive opinion. Hence, it can be said that the critical appraisal was conducted in an efficient manner as for a proper review to be conducted, it is important that two individual researchers critically access the reviews and help in comprehending the results (Gomez-Urquiza et al., 2016). In this systematic review there were two teams appointed for conducting the review and at the same time there was a third team that was responsible for helping in deducing an opinion in case of a deadlock (Meyer et al., 2015). Hence, it can be said that the critical appraisal was conducted by two review teams in an efficient manner.
JBI Critique Tool
Yes, there was a provision to minimize errors during data extraction. This could have been achieved with the help of better filter tools or better data extraction tools. The authors could have also made use of pilot study to minimize the possibility of errors in data extraction (Oyeleye et al., 2013). Also, use of statistical analysis tools could have helped in minimizing the errors in data extraction. Both the review teams responsible for conducting the systematic review could have proceeded with the sound statistical analytical tools in order to minimize errors and chances of duplicity in terms of the idea and key findings of the research (Patricia Potter et al., 2013).
No, the method used to combine the studies is not appropriate. The systematic review is broadly based upon accessing the research papers on the basis of the MBI scale to measure burnout (Gomez-Urquiza et al., 2016). A meta-analysis could have been performed in order to effectively stipulate the findings of the result. The findings from the systematic review are extremely generalized and the use of the MBI scale is not appropriate with the nursing professional’s burnout index. It could be strongly correlated to the nursing providers. Hence, it can be said that the paper lacks a proper method to summarize the findings of the research studies. It can also be stated that quantitative and statistical data could have effectively helped in evaluating the concerned population of the nursing professionals especially oncology nursing professionals falling under the category of psychological burnout. The analysis solely based on the qualitative research finding sis extremely subjective and cannot be considered substantial (Traeger et al., 2013).
This question does not hold valid in this context of research study, as the systematic review was mainly based on the research papers that dealt with qualitative analysis, and the research results based upon qualitative analysis do not hold an association with the likelihood of publication biasness.
No, recommendations were not supported by the reported data. In fact, it can be said that the paper talks more about the risk factors and the assessment of the factors that cause burnout in oncology nursing professionals (Gomez-Urquiza et al., 2016). But, recommendations based on reported or documented evidences are not supported in the paper.
No, the paper does not actually identify the literature gap effectively and because of not being able to identify the literature gap, the paper is also not able to incorporate avenues or guidelines that could be taken up by researchers in future to build up upon the findings of the research (Gomez-Urquiza et al., 2016). Due to the lack of a proper and identified literature gap it can be said that the no specific directives have been retrieved from the systematic review and hence it does not serve as a promising research that could yield the possibility of processing more ideas and building upon a new theme of research interlinked to the findings and the rational of this systematic review.
Conclusion:
Hence, to conclude it can be said that the systematic review is broadly based upon the key PICO elements and identifies the key reasons that are responsible for causing burnout in the nursing professionals. The paper critically evaluates the causes that are responsible for causing burnout in the nurses and at the same time also tries to access the level of burnout using an obsolete scale of MBI which is not aligned with the proper study of nursing professional’s burnout. The paper considers the risk factors but however does not include any recommendations to combat the risk factors or even the paper does not document the availability of critical documents or reports to support the interventions that could be devised in order to effectively reduce the scenario of burnout. The systematic review paper that had been chosen by me is critiqued and evaluated with the help of the critique tool the JBI tool. The paper has been addressed with the proper critical assessment in accordance with the questions furnished by the JBI critique tool in alignment with the systematic reviews. Although, the psychological burnout phenomenon in nursing professional is an extremely significant aspect that attracts attention, however the paper that have been evaluated by me includes an equal number of positive and negative points that have been explained with precision while answering the critique questions. Hence, it can be said that on being able to critically appraise a research article it becomes all the more convenient to understand and apprehend the strengths and weaknesses associated with the study and accordingly develop guidelines for pursing future researches based on the similar theme.
References:
Davis, S., Lind, B. K., & Sorensen, C. (2013, July). A comparison of burnout among oncology nurses working in adult and pediatric inpatient and outpatient settings. In Oncology Nursing Forum (Vol. 40, No. 4).
Drury, V., Craigie, M., Francis, K., Aoun, S., & Hegney, D. G. (2014). Compassion satisfaction, compassion fatigue, anxiety, depression and stress in registered nurses in A ustralia: Phase 2 results. Journal of Nursing Management, 22(4), 519-531.
Foureur, M., Besley, K., Burton, G., Yu, N., & Crisp, J. (2013). Enhancing the resilience of nurses and midwives: Pilot of a mindfulnessbased program for increased health, sense of coherence and decreased depression, anxiety and stress. Contemporary nurse, 45(1), 114-125.
Gomez-Urquiza, J. L., Aneas-López, A. B., la Fuente-Solana, D., Emilia, I., Albendín-García, L., & Díaz-Rodríguez, L. (2016, May). Prevalence, Risk Factors, and Levels of Burnout Among Oncology Nurses: A Systematic Review. In Oncology nursing forum (Vol. 43, No. 3).
Guveli, H., Anuk, D., Oflaz, S., Guveli, M. E., Yildirim, N. K., Ozkan, M., & Ozkan, S. (2015). Oncology staff: burnout, job satisfaction and coping with stress. Psycho?Oncology, 24(8), 926-931.
Hegney, D. G., Craigie, M., Hemsworth, D., Osseiran?Moisson, R., Aoun, S., Francis, K., & Drury, V. (2014). Compassion satisfaction, compassion fatigue, anxiety, depression and stress in registered nurses in A ustralia: study 1 results. Journal of Nursing Management, 22(4), 506-518.
Jones, M. C., Wells, M., Gao, C., Cassidy, B., & Davie, J. (2013). Work stress and well?being in oncology settings: a multidisciplinary study of health care professionals. Psycho?oncology, 22(1), 46-53.
Li, A., Early, S. F., Mahrer, N. E., Klaristenfeld, J. L., & Gold, J. I. (2014). Group cohesion and organizational commitment: protective factors for nurse residents' job satisfaction, compassion fatigue, compassion satisfaction, and burnout. Journal of Professional Nursing, 30(1), 89-99.
Meyer, R. M., Li, A., Klaristenfeld, J., & Gold, J. I. (2015). Pediatric novice nurses: examining compassion fatigue as a mediator between stress exposure and compassion satisfaction, burnout, and job satisfaction. Journal of pediatric nursing, 30(1), 174-183.
Oyeleye, O., Hanson, P., O’connor, N., & Dunn, D. (2013). Relationship of workplace incivility, stress, and burnout on nurses’ turnover intentions and psychological empowerment. Journal of Nursing Administration, 43(10), 536-542.
Patricia Potter, R. N., Julia Allen Berger DMin, B. C. C., & Sarah Olsen RN, B. S. (2013, March). Evaluation of a compassion fatigue resiliency program for oncology nurses. In Oncology Nursing Forum (Vol. 40, No. 2, p. 180). Oncology Nursing Society.
Traeger, L., Park, E. R., Sporn, N., Repper-DeLisi, J., Convery, M. S., Jacobo, M., & Pin, W. F. (2013, July). Development and evaluation of targeted psychological skills training for oncology nurses in managing stressful patient and family encounters. In Oncology nursing forum (Vol. 40).
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